Happy Thanksgiving!!!

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To those of you who celebrate this holiday,

I’d like to wish you and your family a very happy thanksgiving this year…

Thanks for all your kind support and contributions to Med 2.0

Introducing Erik van der Zijden (DigiRedo) — My New Co-Blogger

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If you’ve been following Med 2.0 for a while, let me first thank you for your support; but as you may know, I am almost constantly playing the catch-up game and not always able to publish new blog posts as often as I would really like.

So, in order to help lighten the load a little and also to bring a fresh (and international) perspective to the blog, I’ve asked my friend, Erik van der Zijden from Holland, to help guest/co-blog on Med 2.0.

Erik van der Zijden and Shwen Gwee

Erik works at Intervet/Schering-Plough (in Holland) and is also the co-founder of DigiRedo — a new media agency with a focus on pharma and healthcare. Erik has plenty of experience with Web 2.0, social media, and traditional media as well, and you can read his blog posts on the DigiRedo blog.

I first met Erik — together with his colleagues/friends, Rene and Annemieke — earlier this year at the 2008 New Media Expo in Las Vegas, NV. After spending an evening with them chatting over dinner, we all discovered that we share the same passion for bringing Web 2.0 and social media into the world of medicine, pharma, and healthcare.

So it is with that common passsion and goal, that I am glad to invite Erik to share this blog space with me and look forward to his upcoming posts and media updates (Erik does a lot of video and multimedia work). I’m sure you’ll all enjoy them too!

Wikipedia vs. Medscape Drug Reference: A Case of Omission vs. Inaccuracy?

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This blog post was inspired by the following tweet (twitter post) by Jason Calacanis on NOV 24th, 2009:

The URL posted by Calacanis links to a Reuters UK news release entitled “Wikipedia Often Omits Important Drug Information“. Obviously, with such a title, my interest was piqued.

The article — which is based on findings presented in The Annals of Pharmacotherapy, December 2008 — basically states…

Consumers who rely on the user-edited Web resource Wikipedia for information on medications are putting themselves at risk of potentially harmful drug interactions and adverse effects, new research shows…

The researchers compared Wikipedia to Medscape Drug Reference (MDR), a peer-reviewed, free site, by looking for answers to 80 different questions covering eight categories of drug information, for example adverse drug events, dosages, and mechanism of action.

What the researchers found, was that MDR answered more than 80% of the questions, while Wikipedia only answered 40%, and Wikipedia answers were less likely to be complete — for example, the Wikipedia entry for the anti-inflammatory drug, Arthrotec (diclofena and misoprostol), was missing information that it can cause women to miscarry.

Thus, the researchers advised that “
If people went and used this as a sole or authoritative source without contacting a health professional… those are the types of negative impacts that can occur“.

While I would definitely agree with that statement, one would probably conclude from what was stated so far, that we should NOT rely
on user generated and maintained content sources, such as Wikipedia; but rely more on professional, peer-reviewed resources, such as Medscape Drug Reference.

However, the article goes on to say that although Wikipedia tended to have a higher number of “errors of omission” (48 omissions, compared to MDR’s 14 omissions), it had FEWER factual errors, while MDR had 4 factual inaccuracies!!! This is a peer-reviewed professional resource, folks… It’s what physicians and other medical professionals use to look up drug information… And it’s got more errors than a user generated/maintained wiki. WOW!

“Of the answers the researchers found on Wikipedia, none were factually inaccurate, while there were four inaccurate answers in MDR.”

Additionally, the researchers also found that “…after 90 days, the Wikipedia entries showed a “marked improvement” in scope“. Not sure exactly what they mean by that, but I can only assume that some of the wiki-contributors submitted more information about the drugs they were evaluating(perhaps reducing the amount of info that had previously been omitted), which IMHO demonstrates the true power (multitude of “editors”), flexibility + speed (no editorial/review committee delays), and wisdom-of-crowds type network effect of a wiki-based resource.

So, I’ve got a few issues with this study (in case you can’t tell)…

    First and foremost, it’s not really fair to compare Wikipedia against a professional, peer-reviewed resource like MDR, especially when the researchers are obviously evaluating from the perspective of a consumer and not a medical professional. Instead, why didn’t they compare Wikipedia to WebMD or a similar Health 2.0 drug directory? That would probably be more balanced.
    It could be argued that MDR has a higher chance of inaccuracies because it contains more content and more detail (>80% answers), but then I have to question how a peer-reviewed professional resource that goes through a thorough editorial review process can end up with 4 inaccuracies in 80 questions (that’s 1 inaccuracy for every 20 questions).

    Furthermore, at least Wikipedia entries are probably closely monitored and updated, allowing for additional updates and/or corrections to occur on a regular basis; whereas I would imagine that not much gets changed to content on MDR after it’s passed through the editorial process and published (unless there are changes to the label/indication or they receive complaints, of course). In fact, here’s a quote from the article that certainly implies that the inaccuracies are as dangerous as the omissions, if not more so (infer what you will from this):

    “I think that these errors of omission can be just as dangerous” as inaccuracies, Clauson told Reuters Health.

    On a similar note to #2, if the worry is that omissions by Wikipedia may lead to users being misinformed about a drug, then I think there also needs to be an examination of the types of perception that people have when using each application. I can’t say for sure, but I would think that most people use Wikipedia as an entry point for research, much like Google. Most people probably understand the wiki (user-maintained) concept and therefore treat the information as “exploratory”. They may then go on to find more in-depth information on more trusted, authoritative sites… Sites like Medscape, perhaps.

    On the contrary, when someone uses Medscape — being a professionally-oriented, peer-reviewed, and funded resource — they EXPECT to receive detailed, accurate information that doesn’t require further research or confirmation. It is, after all, called a drug REFERENCE. So, perhaps the title (and contents?) of the article is misleading, in that it is strongly biased against the Wikipedia omissions and does not address the issue of the MDR inaccuracies whatsoever.

    Finally, when it comes to information seeking and, more importantly, finding the right information, it all boils down to how easy it is to navigate through an application and find what you are looking for (i.e. ease of use). And to that end, when you look at MDR as a starting point for consumers to search for a drug and comprehend what they’re being presented, then I think you’ll immediately understand why people turn to Wikipedia first. MDR was really designed for medical professionals (Medscape is the professional facing arm of WebMD), so it’s built for people that understand medicine and can easily navigate through complex information.

    On the other hand, Wikipedia is (mostly) written by general consumers for general consumers, so the level of complexity and the way that it’s written is completely different (AFAIK, no paid medical writers on staff at Wikipedia).If you wan to experience this, just try searching for one of the drugs mentioned in the article, darunavir (I just picked that one at random). First try MDR and you’ll see the search result screen is already confusing — is it the oral form? Good thing there’s only one choice (you should try some others with multiple options). Hmm…

    Next, click on the link and look at all the confusing options — would you know where to find the info you want?

    OK, now let’s take a look at the same search in Wikipedia…

    As you can see, you are immediately greeted by a much less “clutter” and a definition of the term up front that confirms what you are looking for, as well as breaks it down less complexity. There are also a ton of outbound links for finding additional info/resources, as well as anchors within the page for more info on efficacy, safety, dosing, etc.

So, while I am definitely NOT saying that Wikipedia is a better resource than peer-reviewed resources, I am trying to bring balance to an article that seems to unfairly place Wikipedia in a negative light, with regards to being a resource for medical information.

In the end, the ease of use, regular updates, and basic simplicity of Wikipedia — as well as it’s high ranking on search engines — often make it the first stop for a lot of people. It may not be perfect (although it’s been shown to be as good as the Encyclopedia Britanica, which nobody questions as a source), but it definitely has many positive aspects (including accuracy) that this study fails to point out or appreciate. I will give some credit to the researchers for concluding the following, though they still try to make Medscape to be the better option despite it’s inaccuracies:

Wikipedia can be a good jumping-off point for Internet research, Clauson said, but shouldn’t be seen as the last word on any topic-and should certainly not be used as a resource by medical professionals. “You still probably want to go to medlineplus.gov or medscape.com for good quality information that you can feel confident in,” he said.

2009 ePharmaSummit: FEB 9-11, 2009 — $200 Discount Code

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I’m not even ready for the end of 2008 yet, never mind starting to plan for 2009. However, knowing that the new year will be upon us before we know it, I thought it might be prudent to start thinking (and budgeting for) which conferences I might want to attend next year…

One of the key conferences to kick off 2009 that looks poised to be a great event for new and social media in pharma, is the 2009 ePharma Summit which will be held in Philadelphia, PA from FEB 9-11.

— If you’re interested in attending, IIR (the conference organizer) has kindly offered Med 2.0 readers a $200 discount, by using the following priority code: XP1406SG.

Please contact Felipe Alexandre if you have any problems with the code or questions about the conference.

Browsing through the speaker list, there appears to be a good number of really good speakers (that I am familiar with) within the space of new/social media in pharma and consequently, lots of interesting content.

A definite highlight for me and certainly a “non-traditional, outward looking” speaker for pharma, is Josh Bernoff (co-author of Groundswell), who will be presenting “Groundswell: Winning in a World Transformed by Social Technologies“. Very much looking forward to hearing him speak and meeting him in-person.

Moreover, I am also extremely pleased and honored to have been invited to participate in this conference — I’ll be part of the following panel, which will be moderated by Jack Barrette (CEO, WEGO health), whom I recently had the privilege of sharing a panel with at the recent eComm08 conference as well:

Social Media, Blogs and User Generated Content: What’s Working Today, What Will Work Tomorrow?
Back by popular demand, our panel of industry “All-Stars” with a provocative look at the dissolving walls between pharma, patients and physicians, what pharma marketers are doing about it and the obstacles and opportunities that lie ahead in a world where the consumer has more control today than ever. discussion topics include:

  • C to C, Word of Mouth and Viral Marketing
  • Social media – who is really doing it in pharma?
  • Surprise: social media communities don’t hate Pharma
  • Gain a deeper understanding of online media opportunities/social networking
  • The role of Consumer Opinion Leaders in social media influence
  • Web 2.0: A Tactical (and doable!) plan for pharma marketers
  • User-generated content: the smart Pharma marketers don’t want you to know they are already there
  • Breaking the Med Legal strangle-hold on Web Communities – getting to a Social Media “yes” within the archaic legal environment
  • Case studies on using social media programs that directly support strategy, objectives and client goals. Should include social networking, video, blogs, banners, podcasts
  • Using social networking to build relationships with customers
  • Case studies in pharma usage of web 2.0 – Update on social networking sites identifying successful revenue models

Jack Barrette, CEO, WEGO Health

Louis Sanquini, Director, Azelastine Franchise, meda Pharmaceuticals
Kevin H. Nalty, Marketing Director, Dermatology, Merck & Company, Inc.
Raj Amin, CEO, Healthination

If you are planning on attending this conference, leave me a comment or send me an email and I’ll look forward to meeting you there. And if you can’t make it, look out for the live tweets from Steve Woodruff (who I’m sure will be live-tweeting and maybe even live-blogging) and myself. Steve’s going to be on the same panel as well.

Twitter for Business: The Video…

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For those of you who missed the recent O’Reilly webcast on Twitter for Business (by Sarah Milstein), O’Reilly Media has now uploaded it to their YouTube Channel and I have also embedded it here in this post for easy viewing…

The webcast/video is another nice primer for beginners and for helping people understand how Twitter is adapted for use in big businesses and offers some great (and some often quoted) examples like: Comcast, Zappos, Starbucks, JetBlue, Whole Foods, Ford, etc.

At the end of her presentation, Milstein concludes with the following three points about Twittering for Business (which you’ve probably heard in previous Social Media presentations as well):

  1. Monitor buzz
  2. Engage customers
  3. Authentic & transparent

So, while there isn’t any real pharma or medicine based examples, it’s a great starting point if you need some real world examples and ideas for how Twitter is being used by businesses. Hope you find it useful.

Motrin Marketing Feels the Pain and the Power of Social Media

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If you haven’t heard about the HUGE #MotrinMoms furor that erupted this past weeekend, then you must not have seen the multitude of tweets, blogs, and YouTube videos that escalated and intensified throughout Sunday (NOV 16), culminating in the Motrin.com website going down by Sunday evening (“Network Error” message).

In brief, J&J/McNeil Consumer Healthcare rolled out an online video on the brand website for Motrin.com, which over course of a day, infuriated what appeared to be hundreds, if not thousands, of people. Here’s a video that was “inspired” by all the negative comments…


I’m not sure exactly when the offensive Motrin video was launched, but it was picked up on Sunday by some “mommy bloggers”, who then spread the word through Twitter and within hours, it spread far and wide enough to generate a HUGE negative response and viral backlash towards Motrin and J&J/McNeil — some even calling for a boycott of the brand. Although the website finally went down (or got pulled???) by Sunday evening, it was already too late, as the video was uploaded to YouTube for “permanent preservation” in the halls of infamy. You can also see screenshots of the ad on the Small Dots blog.

To be perfectly honest, I’m not a parent, so I probably didn’t take as much offense to the ad as many other folks did, but I can definitely see their point of view.

I watched the whole event transpire throughout Sunday and it was probably one of the most impressive examples of the power of social media that I have seen unfold in front of my eyes…

The key source of conversation and spread was Twitter, which then lead to an escalation of negative blog postings, and then YouTube video responses (and it continues to grow). You can see the aggregation of Twitter streams using the #MotrinMoms and/or #Motrin hashtags, which by the way, was getting tweets by the hundreds every few mintues.

On the positive side, it appears that the VP of Marketing at McNeil has made an effort to reach out and apologize to some bloggers, but the damage may already have been done. Mind you, this was on a Sunday evening, though it’s probably no surprise that they got wind of the situation, as the fervor built over the course of the day, including some emails from folks I know personally to folks at McNeil.

So what’s my take on all this?

Well, I think the key take away from all this is that this is a case where NOT engaging in social media may actually have caused more harm to the brand than if one had engaged in social media, particularly among the target audience. And to now try to engage an audience that has even threatened to boycott your product, means having to climb a “barrier of trust” the size of Everest (or greater, depending on how they choose to respond).

At the very least, one could have engaged the influentials within the target audience (i.e. key mommy bloggers) and ask their opinion of the ad before it gets released to the wild… After all, almost anyone operating in this space will know the importance of mommy bloggers these days. Perhaps market research was done, but one has to remember that in traditional market research, WE are the ones asking the questions and controlling the conversation.

A key question that I was asked by a thought leader in the social media business was: …why didn’t they understand the momblogger audience better before they launched the campaign? and to that, I had to respond that it could possibly be due to “traditional pharma marketing” thinking — the marketing team is sold on an idea by their ad agency and only sees/hears what the agency tells them. Not sure if this is the case, but obviously the current breath of the outrage seems to indicate that even a small amount of social engagement/ interaction regarding the ad may have hinted to what might ensue.

Not to judge anyone at McNeil or their ad agency (apparently, Taxi NYC), but I would have thought a J&J company — if anyone — would have “got it” more than others, as J&J already has blogs, a YouTube Channel, and more. However, it’s a good wake up call to remind us that even the most seemingly harmless and well-intentioned concepts can go awry very quickly. And in this socially engaged and hyper-connected world, a negative message can spread much further and faster than you could ever imagine… Welcome to the Groundswell!

NOTE: Just before posting this, I noticed that the Motrin website is back up again, with an apology note posted in place of the video. Here’s what it says…

UPDATE  (11/18): Kathy Widmer (VP, Marketing @ McNeil) has also posted a response to all this via the J&J blog, JNNBTW.com. It is a good thing that they have already been engaging people through their blog and have offered a mea culpa response (they even start with “We hear you…“), as well as a solution for the future — a lesson that we all learned from JetBlue.

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